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Review
. 2015 Mar 21;385(9973):1136-45.
doi: 10.1016/S0140-6736(13)62708-7. Epub 2014 Oct 21.

Typhoid fever

John Wain  1 , Rene S Hendriksen  2 , Matthew L Mikoleit  3 , Karen H Keddy  4 , R Leon Ochiai  5
Affiliations
Review

Typhoid fever

John Wain et al. Lancet. .

Abstract

Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures.

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Conflict of interest statement

Declaration of interests

KHK is a permanent employee of the National Institute for Communicable Diseases, South Africa. MLM is a permanent employee of the US Government (Department of Health and Human Services, Centers for Disease Control and Prevention). The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. RSH is permanently employed by the Technical University of Denmark, National Food Institute. JW is the Chief Scientific Officer and Director for Discuva, an antibiotic discovery company. RLO is currently an employee of SanofiPasteur, which is a producer of typhoid vaccine. He was formerly an employee of the International Vaccine Institute, Seoul, Korea and independent at the time of writing

Figures

Figure 1:
Figure 1:. Mortality from enteric fever worldwide
Data from Jan 1, 2012, to Dec 31, 2012. 5 741 344 total deaths. CKD=chronic kidney disease. Used from Lozano and colleagues.
Figure 2:
Figure 2:. Worldwide distribution of antimicrobial drug resistance in Salmonella enterica serovar Typhi
MDR is defined as resistance to the first-line antimicrobial drugs ampicillin, co-trimoxazole, and chloramphenicol. MDR=multi-drug resistant. ESBL=extended-spectrum beta-lactamase-producer. Adapted from Bhan and colleagues, with data up to April, 2013.
See this image and copyright information in PMC

References

    1. Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. J Glob Health 2012; 2: 10401. - PMC - PubMed
    1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2095–128. - PMC - PubMed
    1. Khan KH. Recent trends in typhoid research—A Review. Int J Biosci 2012; 2: 110–20.
    1. Parry CM, Wijedoru L, Arjyal A, Baker S. The utility of diagnostic tests for enteric fever in endemic locations. Expert Rev Anti Infect Ther 2011; 9: 711–25. - PubMed
    1. Wain J, Hosoglu S. The laboratory diagnosis of enteric fever. J Infect Dev Ctries 2008; 2: 421–25. - PubMed

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